Whenever you get the opportunity to talk with colleagues who also work in community pharmacy, you find yourselves making comparisons about your work.
How many items do you do? We can’t get this in stock, can you?
What patient medication record system do you use?
I find one particular comparison most interesting…
How many staff do you have?
There is no hard and fast rule for how many staff each pharmacy should have on duty at any one time. Other than there being a pharmacist on duty for the day, it really just depends on what the employer chooses to do with everybody else. This is something I feel incredibly strongly about since not enough staff is a huge risk to patients and to the pharmacist.
If you’ve read my blog on why you have to wait for your prescriptions, or you work in pharmacy, you’ll understand what goes on in the dispensary. Queuing patients add a lot of pressure to the processes we do and we often find ourselves rushing round to ensure we manage the queues and get people sorted safely.
But how safe is safe? Not having enough dispensing or counter staff means the burden of work is increased on each member of staff, rather than shared between more people. The dispensers are more likely to make mistakes rushing around the dispensary grabbing boxes off of the shelves and they could easily mistype labels as their fingers speed across the computer keyboard, whilst they have one eye on the growing queue over the top of the screen. With not enough staff to manage the queue, the pharmacist will be required more in the dispensing process or to serve over the counter to help manage how busy things are. And whilst immediate queues are being managed, there are no members of staff free to keep on top of the pile of prescriptions that came from the surgery.
When there is not enough staff in a pharmacy, rushing happens quite naturally as the workload still needs to be managed but with fewer people. The pharmacy team becomes more fatigued due to increased strain on each member and fatigue affects our ability to concentrate on the work. If the pharmacist is needing to get involved in the dispensing process, for example labelling the prescription whilst their colleague is serving the next person, or picking the items whilst their colleague starts labelling the next person’s prescription, this adds to the risk.
When a pharmacist checks a prescription, if they are seeing the prescription and the items and the labels for the first time, they are more likely to pick up any mistakes in the accuracy check than if they have been involved in putting it together. It’s quite simple to understand the principle that it is easier to notice the mistakes of someone else rather than your own.
But why, when this is clearly understandable, are pharmacies of today not staffed safely to manage risk? I hear all kinds of stories from colleagues and through pharmacy social media groups about staffing. I know how it feels to work under immense pressure and worry about it afterwards. I know how it feels to work to the point of being exhausted.
Nationally, we need something in place to manage staffing levels so that pharmacy staff aren’t under unmanageable pressures. Unless you work in that particular pharmacy, you can’t possibly understand the day-to-day patterns of workflow, nor can you rely on technology to tell you that information. Rather than suffer the stress of understaffing, we need to speak up for it. We need to prevent risk rather than manage it. We need to have confidence that we are doing all that we can to minimise making mistakes that our patients could suffer from.
In our job, understaffing doesn’t just mean that the work builds up a bit. It doesn’t just mean that the next few days will be busier or that the job won’t get done as quickly. It could mean that Mrs Smith accidentally gets the wrong warfarin strength and ends up in the hospital, seriously ill from an overdose. It could mean that a patient gets the wrong strength of blood pressure medicines and becomes excessively dizzy, falls and breaks their hip. It could mean that somebody accidentally gets a medicine that sedates them and they drive for a living, what could go wrong?
Staffing levels directly impact on patient safety. It isn’t a matter to trifle with.
We need our staff to be safe for our patients.
Laura Buckley is a community pharmacist who runs a very successful blog. She is passionate about pharmacy and about parenting. Support her by checking out her blog by clicking here.